Q: David: What has been your experience with a
prescribed to a patient who is bipolar/schizo-affective who is also taking
and Tegretol. I have read that Prozac (or other tricyclic antidepressants
can cause psychotic events to occur. Thank you......
I am a psychologist, not a physician and therefore am not involved in the
prescribing of medication. I have been on Prozac in the past for depression
without any side effects and have a 22 year old son who has been prescribed same
for the past two years for ADD with no problems as well.
Prozac or drugs which work on the same principle as Prozac -- Zoloft,
Luvox, Paxil, Celexa etc. , are known as selective serotonin reuptake inhibitors
(SSRIs) and are designed to block the metabolism of serotonin, thereby
increasing levels of this neurotransmitter in the brain.
In the June 1999 edition of Clinical Psychiatry News for example, Dr. Malcolm
Bowers, a psychiatrist at Yale had found that physicians are not paying enough
attention to patient factors that could make treatment with SSRIs dangerous. He
found that, "SSRI induced psychosis has accounted for eight percent of all
hospital psychiatric admissions over a 14-month period...What is surprising is
that this particular group of side effects is really underplayed."
Tricyclic antidepressants are a class of antidepressant drugs first used in the
1950s. For many years they were the first choice for pharmacological treatment
of depression. Although still considered effective, they have been increasingly
replaced by SSRIs and other newer drugs. These newer antidepressants are thought
to have fewer side effects and are also thought to be less effective if used in
a suicide attempt, as the treatment and lethal doses are farther apart than with
the tricyclic antidepressants.
Multi-Drug Interaction Checker (Medscape from WebMD)
FLUOXETINE ORAL (Prozac)
Tegretol Oral and Fluoxetine Oral may interact based on the potential
interaction between CARBAMAZEPINE and SELECTED SSRI'S.
This information is generalized and not intended as specific medical advice.
Consult your healthcare professional before taking or DISCONTINUING any drug or
commencing any course of treatment.
MONOGRAPH TITLE: Carbamazepine/Selected Selective Serotonin Reuptake
SEVERITY LEVEL: 3-Moderate Interaction: Assess the risk to the patient and take
action as needed.
Remember to discuss this with your physician first and foremost. Psychosis
can also be a symptom of both bipolar and schizoaffective disorders.
Communicate openly about all of the symptoms and behaviors and allow your
psychiatrist to be as persistent as possible in getting as much information as
he or she can from you.
David Schafer, M.Ed.
Published April, 2006